| NPI | 1134649478 |
|---|---|
| Former Name | KAILEY EDGAR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-12983) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MT PTP-PT-LIC-12983) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2023-01-12 |